Your Doctor - an opinion I think worth considering

[NavyDiver]

"At the end of every workday as a busy GP, I feel like I have run a marathon. No - like I have sprinted from case to case. From my current vantage point (I’m on maternity leave) I’ve had time to wipe the sweat from my brow and take a long drink. And what I can see is a health sector that is imploding around us.
Reports of ambulances ramped for hours, bloated elective surgery waitlists, and the decline in care standards across the board fill our newsfeeds daily, no matter which state or territory we are in. And at the epicentre of the issue is the missing GP. Where have they all gone?

"
I will be gone from managing General Practice in a year or two. I hope some of the Doctors stay of course.

"We do not have enough GPs managing this chronic care – which is what we do best as GPs. Without a competent GP, these patients get sicker and sicker, very slowly, eventually getting to a crisis point where they have no choice but to be admitted for high-level care in our hospitals....

President of the Royal Australian College of General Practitioners Karen Price recently pointed out, general practice provides 177 million services a year to 24 million people (https://www1.racgp.org.au/newsgp/racgp/general-practice-summit-we-have-a-crisis-on-our-ha), but receives only 7.4 per cent of the entire health budget.
You see, money makes the world go around - and this includes healthcare."


With insulting red tape, rulz, incompetent bureaucratic types I think Dr Samantha Saling (https://www.theage.com.au/by/dr-samantha-saling-p535yw) nails it! A surgeon I know tossing a $400+ bill for a 15 minute chat or a GP paid $30ish. Easy to see why walking away will be very easy!
A complaint I took yesterday about a very busy doctor not able to see a person for an appointment. That person:

had called after 2pm demanding the appointment :)
Told me they know how rich GPs are
Was shocked they could not find another GP to complain too


Putting my accounts up $10 tomorrow. Its still well under the Indexation for the Medicare rate when first introduced. I will have tin foil hats for my staff! It will not be many but it will happen.


Doctors: Why ‘invisible’ GPs are quitting in droves (https://www.theage.com.au/lifestyle/health-and-wellness/why-invisible-gps-are-quitting-in-droves-20221010-p5bonv.html)

[Bulletman]

It makes me sad and angry when I read this type of post. Real world experience explains how it really is yet every political party will try and spin it otherwise .

I'm very lucky that before I left Darwin I had a very good GP and since relocating to Perth it's only early days but I seem to have also found a good GP.

Our eldest daughter is a kidney dialysis educator having worked her way up from a RN. She has been abused , threatened , and generally been poorly treated by those who she is trying to help as due to staff shortages she still spends most days on the ward or in the day clinic. I will be surprised if she stays in the medical field much longer as she also says the system is very broken .

Hopefully sooner rather than later eyes are opened and things start to improve before it's too late, even tho it seems we have passed that point .

Cheers Bulletman

[cjc_td5]

It is not helped by the evolving trend of younger professionals refusing point blank to do on-call or after hours work. They state for their work-life balance and mental health. This puts a larger burden on the older professionals and leads to their earlier exit from the system. I've heard of Opthal registrars walking out the door at 5pm saying they're finished, when there are still patients in the waiting room.....

[austastar]

Hi,
The armed services seem to have a good working model.
Regular checkups help keep the troops healthy as well.
Cheers

[ATH]

Can't get an appointment with our usual GP for around a fortnight at the earliest. Half the doctors in his practice have gone supposedly for training in whatever they fancy becoming specialists in. One reason so much money has to be poured into the health services is the huge amount of seat polishers in hospitals. I did what they term a DAMA (Discharge Against Medical Advice) after having a knee replacement as I didn't trust the RN on duty after a couple of incidents which I won't go into.
Struggling around the hospital using a frame and carrying a bag with only one working leg looking for an exit, I wandered through miles of dark corridors which are alive with people all dashing around from office to office during the day.
A nurse coming on duty reported me to whoever she could but no one showed interest as to why I was going and I just kept going until I eventually got out as other people pressed the button to open doors and enter the hospital.
Into a cab where I received a call from a doctor asking me to report to my local hospital and they would look after me which I did but left the next day full of pain killers.
A top heavy system where the people at the coal face are definitely in a minority, they try hard and most do well in looking after us who need it. I know I should have reported the nurse but I really couldn't be bloody bothered in the end and let it go.
I don't blame GPs for trying to get out and specialise.
AlanH.

[scarry]

I had a good GP here as well.
Then he went to a bigger clinic just around the corner.
No appointments so it has become pot luck.
Go there and i usually have to wait a couple of hours to see him,at least,time i dont have.
Even to to see any doctor takes at least an hour or two, waiting around.

So on the days he starts at 7,i have to get there at 6.30 and stand in line,there is usually around 6 people already there.
Its becoming a PITA,maybe, unfortunately, i will move on.

[NavyDiver]

Hi,
The armed services seem to have a good working model.
Regular checkups help keep the troops healthy as well.
Cheers

Interesting tour of the hospital on HMAS Adelaide. Doctors. Surgeons, nurses to fill it are called in from reserve . They are your Doctors. Surgeons, nurses who are taken when needed.

Army and airforce is a bit above my knowledge base, Navy has medics and the Doctors tend to be borrowed. I am sure a few are full time of course. Only regular check up I had was Diving Medical Clearance every year.

A lot easier than to see my GP now [bigwhistle][bigwhistle][bigwhistle] I could jack the line but that's not like me. Lucky to be on zero medicines myself.

I think twenty plus Sorry we are full this week so far. The mess is not being helped by other assumed "priorities" for some people who are smarter than you or I (Not)

[V8Ian]

I was speaking to a girl who was a radiologist, at a private practice in Ipswich. Turns out she was a full time Raafy posted to Amberley, working in the private sector because A: the RAAF didn't have enough work for her and B: didn't have the equipment needed to keep her skills current.

[disco gazza]

I rang my GP the other day for a ph appt just to get a new script.
First available is 29th this month.
Its usually a 2 week wait,but now it seems 3 weeks will be the new normal.


DG

[Arch]

If the GPs are finding a bit hard and the job is not meeting their pay or lifestyle expectations, maybe it's time to expand the role of nurses to take on some of the duties a GP provides.

I'm sure an extra career path for nurses would solve a lot of problems in the General Practice space while going some distance to address the pay problem for experienced nurses.

[Saitch]

Part of the problem appears to be financially induced, with health monies being incorrectly allocated.

A few years ago, a certain state government invested in state of the art, imaging machines and facilities to house them, in a fast growing, outer region, residential development.

As far as I'm aware, these machines have never been commissioned, as there are no suitably qualified, 'Medical Imaging' bods to operate these particular machines.

[DiscoMick]

Medicare rebates for GPs have been frozen for several years, but their costs keep rising, so it's not surprising GPs are putting up charges to cover the difference.

[scarry]

Medicare rebates for GPs have been frozen for several years, but their costs keep rising, so it's not surprising GPs are putting up charges to cover the difference.

Yes bulk billing will go the same way as the dinosaurs.

Agree the nurses could be allowed to do more,I have found often the nurses know as much if not more about a problem than the attending Doctor,particularly in regional areas.

[austastar]

Hi,
I would rather pay my hospital insurance to the hospital for cover, rather than a bunch of shiny bums in a corporate office.
Cheers

[jonesfam]

We usually have 1 or 2 Nurse Practitioners at one of our clinics + a Doctor 2 weeks on 1 week off.
I prefer to see the Nurses because at least 1 is always here & they have been here a long while so know me & my history.
The Doctors change a lot.
The hospital seems to struggle for Nurses & Doctors.
The hospital is state funded, the clinic is federal.
Jonesfam

[Bulletman]

This is based purely on my observations and may be different in other areas but my GP clinic when we were living in Darwin started to bulk bill several years before I left and it went from being able to get an appointment with my GP very easily and very rarely did the allocated time slot blow out by 5mins, to being making an appointment for a week later as nothing was available with my GP any earlier and when I did turn up I usually waited an extra 30mins sometimes longer.
About 9 months before I left they went back to non bulk billing and low and behold it went back to the days of old.
Now I know nothing of how the system works but it seems bulk billing altho convenient plays a big part in putting pressure on a GP clinic. So if there are very few clinic options then I can see this not only overloads the clinic but surely those GP in that clinic.
Cheers Bulletman

[Arch]

Hi,
I would rather pay my hospital insurance to the hospital for cover, rather than a bunch of shiny bums in a corporate office.
Cheers

I pay the medicare levy surcharge for this reason.

[Don 130]

I pay the medicare levy surcharge for this reason.

Us too.
Don

[NavyDiver]

Hi,
I would rather pay my hospital insurance to the hospital for cover, rather than a bunch of shiny bums in a corporate office.
Cheers

Fully understand that yet I do see times when it fails in a major and hurtful way.

Knees, hips, plastic surgery (Elective Surgery) and many other "hospital Out patients services" from public hospitals are usually very very long waiting lists.

A bike riding lady in hospital with me is in the public waiting list line again and again and again even now 3 years after our injuries. She was hurt significantly less than I was. She is struggling to get the care needed in the public system as she had no insurance at all. She was as fit as I was before. That is not true now due to the public out patients care she is still waiting for.

All most every one with chronic pain/mobility in those public waiting list suffers. Those with insurance going private cut that time frame by years often.

Public Emergency care is just fanatic in the public sector for heart attacks and cancer!

I love Royal Melbourne Hospital for sticking me back together. I did need help which was urgent but not an emergency an I could not get if from them. I broke one of the screws holding the titanium rod in my leg (tibia). Letters and multiple phone calls to the hospital where completely ignored! The helpful phone person was honest that the surgical area phone was never answered as they where to busy!

Perhaps had I called an ambulance it may have been different. Insurance had me fixed very quickly in the Private sector.

I get to see many people in the "No Insurance" group who really wish they had insurance for chronic but not emergency injuries and issues. That is a place not to be if you can avoid it.

This is possibly much more important as we get older and more likely to have chronic issues!

Not suggesting this is OK- It is true and known often after the chronic but not emergency injuries and issues are found!

[Roverlord off road spares]

Mario was lucky with his doctor, where he worked at a clinic,and the clinic decided not to do bulk bulking any more. But his doctor made the bill to go bulk billing system, so Mario and I never had to pay . As I was on a part pension carer and he was on my heath card card. AS I am not on the part pension carers any more, I went to the doctor yesterday and I had to pay $66 which I will get most of it back through medicare. The girl at the desk told me that the doctor had lower his bill so I wont be out of pocket to much, maybe $6.00. Once I get thing sorted out here financially, I will be a self retiree, and I will be able to get a low heath care card through centerlink

[RANDLOVER]

I pay the medicare levy surcharge for this reason.

I pay for medical insurance as I have experience of both private and public, and the private is a much nicer, quicker and more efficient experience, probably with better outcomes.

Also worth knowing is even if you are admitted to a public hospital, but then have misgivings you can be transferred to a private one as happened to a friend of mine, who went to a govt. A&E dept. that I think failed to diagnose his condition, so a few weeks later went to another ED and was admitted to a public hospital was then told they'd need to operate, at which point he said words to the effect of "Bulldust get me an ambulance and transfer me to a private hospital!", which duly happened, and he was very happy with his op and recovery.

[scarry]

I pay for medical insurance as I have experience of both private and public, and the private is a much nicer, quicker and more efficient experience, probably with better outcomes.

who went to a govt. A&E dept. that I think failed to diagnose his condition, so a few weeks later went to another ED and was admitted to a public hospital was then told they'd need to operate, at which point he said words to the effect of "Bulldust get me an ambulance and transfer me to a private hospital!", which duly happened, and he was very happy with his op and recovery.

That is exactly what happened to me,although i didnt have an op.Get me out of here i told them.
The nurse in the Ambulance told me what the issue was,the driver radioed ahead,and they were all ready by the time i got there,at the private hospital.
That was after being at the public hospital for 7 hours and seeing two different Doctors who had no idea what the **** they were doing.

[NavyDiver]

Mario was lucky with his doctor, where he worked at a clinic,and the clinic decided not to do bulk bulking any more. But his doctor made the bill to go bulk billing system, so Mario and I never had to pay . As I was on a part pension carer and he was on my heath card card. AS I am not on the part pension carers any more, I went to the doctor yesterday and I had to pay $66 which I will get most of it back through medicare. The girl at the desk told me that the doctor had lower his bill so I wont be out of pocket to much, maybe $6.00. Once I get thing sorted out here financially, I will be a self retiree, and I will be able to get a low heath care card through centerlink

We are Private Heather. We bulk bill a lot for the reasons you know well. Doctors are not greedy sods. They should be paid for the occasionally very distressing hard work they do. Like you I am fairly sure Mario's Doctor (s) are upset with not being able to help.

What I hate is the people who could demanding they do not pay their Doctor. [bigwhistle] People are mostly reasonable. Not always and not everyone. I suspect happily 95% of us are as cool as you are.

PS I love Nurses but know the Knowledge and training are significantly different- Add I am having really nice chemist put a needle in my arm Monday- 3 months post Covid I get the up to date one Bulk Billed by law - Not unhappy with that but note I cannot afford to keep doing the time and red tape Covid vaccines add to our work load[bighmmm]

[4bee]

If the GPs are finding a bit hard and the job is not meeting their pay or lifestyle expectations, maybe it's time to expand the role of nurses to take on some of the duties a GP provides.

I'm sure an extra career path for nurses would solve a lot of problems in the General Practice space while going some distance to address the pay problem for experienced nurses.


I understood Practice Nurses were already able to take the strain especially on minor matters.

[Roverlord off road spares]

We are Private Heather. We bulk bill a lot for the reasons you know well. Doctors are not greedy sods. They should be paid for the occasionally very distressing hard work they do. Like you I am fairly sure Mario's Doctor (s) are upset with not being able to help.

What I hate is the people who could demanding they do not pay their Doctor. [bigwhistle] People are mostly reasonable. Not always and not everyone. I suspect happily 95% of us are as cool as you are.

PS I love Nurses but know the Knowledge and training are significantly different- Add I am having really nice chemist put a needle in my arm Monday- 3 months post Covid I get the up to date one Bulk Billed by law - Not unhappy with that but note I cannot afford to keep doing the time and red tape Covid vaccines add to our work load[bighmmm]


Yes, Mario had a talk to his doctor, when the clinic took bulk bill off, and Mario was quite happy to pay the the new price, but he kept it going through the health care card. He did tell us what he get out of the bulk bill, which isn't that much, but by the time he pays the clinic as well it isn't much at all. I would like to see these people that complain about paying live on the money that doctor get to keep on the bulk billing system, and paying the clinic. And his doctor was upset about not being able to help Mario and it just came down to pain management in the end. And the last 5 month was hard for him to watch the MSA progressing faster every time he saw him.

[jonesfam]

How many years of Uni is it to become a Doctor? 5 or 6?
Then I guess they have a year or 2 of practical on site training before they could do much.
Then they get over worked, underpaid & abused.

If it was me I would do Law or Engineering at Uni - not Doctoring.
Jonesfam

[Saitch]

How many years of Uni is it to become a Doctor? 5 or 6?
Then I guess they have a year or 2 of practical on site training before they could do much.
Then they get over worked, underpaid & abused.

If it was me I would do Law or Engineering at Uni - not Doctoring.
Jonesfam

Dunno, mate. Most doctors I know are beneficial to the community. [biggrin]

[Arch]

Fully understand that yet I do see times when it fails in a major and hurtful way.

Knees, hips, plastic surgery (Elective Surgery) and many other "hospital Out patients services" from public hospitals are usually very very long waiting lists.

A bike riding lady in hospital with me is in the public waiting list line again and again and again even now 3 years after our injuries. She was hurt significantly less than I was. She is struggling to get the care needed in the public system as she had no insurance at all. She was as fit as I was before. That is not true now due to the public out patients care she is still waiting for.

All most every one with chronic pain/mobility in those public waiting list suffers. Those with insurance going private cut that time frame by years often.

Public Emergency care is just fanatic in the public sector for heart attacks and cancer!

I love Royal Melbourne Hospital for sticking me back together. I did need help which was urgent but not an emergency an I could not get if from them. I broke one of the screws holding the titanium rod in my leg (tibia). Letters and multiple phone calls to the hospital where completely ignored! The helpful phone person was honest that the surgical area phone was never answered as they where to busy!

Perhaps had I called an ambulance it may have been different. Insurance had me fixed very quickly in the Private sector.

I get to see many people in the "No Insurance" group who really wish they had insurance for chronic but not emergency injuries and issues. That is a place not to be if you can avoid it.

This is possibly much more important as we get older and more likely to have chronic issues!

Not suggesting this is OK- It is true and known often after the chronic but not emergency injuries and issues are found!


Private health has some advantages for those who can afford it. But for those who can't, the system treats them as second class.

I'm in the no insurance group as I don't believe in the profiteering by multinationals in an essential public service, the gov subsidies in private health (the Herny Review was clear that the money could be better spend in the public system), and the queue jumping - paying to get treatments faster.

The health system here is in dire need of a rethink. Maybe a national conversation without the industry lobbyists on the hill. A greater role for nurses would be a start, a real world medicare rebate and redirecting the private health subsidies to the public health system. Let's not mention the Federation and big issues there. I don't how we deal with the entitlement issues among some of those who graduate with a Dr as their title. Nurses, teachers, etc work hard days as well.

[RANDLOVER]

Private health has some advantages for those who can afford it. But for those who can't, the system treats them as second class.

I'm in the no insurance group as I don't believe in the profiteering by multinationals in an essential public service......

You could join a members only fund like Find a Members Own Health Fund - Members Own (https://www.membersown.com.au/) or Find a fund - Members Health (https://membershealth.com.au/our-funds/find-a-fund/) although they can be bought up by other funds which is what happened to me, I was in AHM but they were made an offer that was too good to refuse according to most of the voting members, so even though I voted "No" I ended up receiving $2000 IIRC.

[Saitch]

I must be unique!

I've never had health insurance and never had a problem with the public health system in Queensland. :spudnikbackflip:

[NavyDiver]

I must be unique!

I've never had health insurance and never had a problem with the public health system in Queensland. :spudnikbackflip:

Navy Health for this Black Duck- Noting I have never used it at all to date[bigrolf]

[Tote]

There seems to be a bit of a fuss being made in some sections of the media about doctors "rorting" medicare at the moment. I am sure that if the medicare rebate actually came close to the cost of servicing patients the temptation to do this would be less. A question maybe for Navy Diver - how corporatised is the GP industry in general? It certainly isn't in Yass with most of the practices falling inn the realm of "small business", however I can see that corporate entities might be tempted to develop ever bigger groups of practices for which the temptation to deliver profits is more important than delivering services. This happen somewhat disastrously in the childcare industry with many big players going broke once the big corporates were forced to become more accountable.

I have witnessed some overservicing at my local practice with pathology reports requested in circumstances where they may be excessive and a solid push to move six monthly appointments to three monthly when there is not a good medical justification, but it is fairly low level. The medical industry does have a very influential lobby group in the AMA and any reform is difficult in the face of claims that "everyone will have to pay to see the doctor" that are raised every time the AMA is displeased.

Medicare fraud: Bulk-billing rates inflated through rorts (https://www.smh.com.au/politics/federal/medicare-rorts-expose-inflated-bulk-billing-rates-20221017-p5bqas.html)

Regards,
Tote

[4bee]

I had a good GP here as well.
Then he went to a bigger clinic just around the corner.
No appointments so it has become pot luck.
Go there and i usually have to wait a couple of hours to see him,at least,time i dont have.
Even to to see any doctor takes at least an hour or two, waiting around.

So on the days he starts at 7,i have to get there at 6.30 and stand in line,there is usually around 6 people already there.
Its becoming a PITA,maybe, unfortunately, i will move on.

Bloody Hell Paul!


I hope that won't apply to our local practice & so far so good, but I am concerned at the Indian folk buying up established practices, they already seem to be well into Geriatric Care. I suppose our dear olde reliable & trusted GP will not be there one day when needed & that will be a sad occasion.

C`est la vie I guess.

[NavyDiver]

There seems to be a bit of a fuss being made in some sections of the media about doctors "rorting" medicare at the moment. I am sure that if the medicare rebate actually came close to the cost of servicing patients the temptation to do this would be less. A question maybe for Navy Diver - how corporatised is the GP industry in general? It certainly isn't in Yass with most of the practices falling inn the realm of "small business", however I can see that corporate entities might be tempted to develop ever bigger groups of practices for which the temptation to deliver profits is more important than delivering services. This happen somewhat disastrously in the childcare industry with many big players going broke once the big corporates were forced to become more accountable.

I have witnessed some overservicing at my local practice with pathology reports requested in circumstances where they may be excessive and a solid push to move six monthly appointments to three monthly when there is not a good medical justification, but it is fairly low level. The medical industry does have a very influential lobby group in the AMA and any reform is difficult in the face of claims that "everyone will have to pay to see the doctor" that are raised every time the AMA is displeased.

Medicare fraud: Bulk-billing rates inflated through rorts (https://www.smh.com.au/politics/federal/medicare-rorts-expose-inflated-bulk-billing-rates-20221017-p5bqas.html)

Regards,
Tote

I think Telstra Health and Telehealth types are trying to be the supermarket of health care. Some or many may even be an overseas Doctor taking some of those calls. Large corporate like Primary Health are a mixed bag of good and trash. With shockingly low out of date rebates Solo GPs are not viable I think.

Rorts are Billing items they should be using so It is a compliance issue. Care plan Item 721 723 are the ones that get up my nose. Only your regular doctor is allowed to bill them to help you access allied health care partly Medicare funded. .

We often find a person has walked in to a once off appointment and those items where billed out side the regulation/requirements. If I call Medicare to find out dates and let them know this RORT has occurred Medicare they do ZIP despite being able to see the items billed by Dr Shonky was never allowed under the rulz!

I know they are doing a compliance audit against a Doctor who bulk billed adding the bulk billing $5 incentive. The Doctor his staff added a health care card or similar which was not that persons.

Medicare can pick $5 bulk billing incentive yet I have never heard of them auditing the one hit wonders which take $100-200 odd from Medicare that they clearly should not! Those might add up to Several thousand per day - The BB incentive might be $100.

FYI The Medicare bulk billing incentive stops the day children turn 16! It should be when they finish school :rulez:

It also give a few cent to Health care card and Pension Card Holders. It should apply to all retired people in my view!:rulez:

rulz are not smart some times and not policed when they should and could be. Give me all the Medicare billing data and My prior Reconstructive accounting tool and I would have hundreds of people needing to give back millions to Medicare. Not going to happen sadly. Its easy to do.



Personally I would like just six items short Medium an complex at $ 40 $90 and $140 with a LONG consultation supplement and the same for unsociable hours being $100 more each. Over time for staff, Doctors and a security supplement if needed! My six is 9 items [biggrin]

Noting I just might sell to a corporate and run away. I would feel awful if the 8000 odd people who are often like family got shafted by that. Much prefer to sell to a GP or two in a partnership.
.

[3toes]

In the UK your GP practice is not part of the NHS they are contractors to the NHS and charge the NHS a standing fee for each person they have on the books.

A profitable person never shows their face in the surgery. Then fees for a visit or to refer them to a service which they may themselves own which will charge the NHS again.

They are paid bonuses for things like the flu jab for hitting targets. This can result in all sorts of requests from doctors who you are not connected with to come in the have what ever is the latest so they can hit their target

Do not upset them as they have the absolute right to remove you from their books and if they do this tell
All the other practices they have done this. As accepting someone into the practice is at the discretion of the surgery this can make it difficult to find another doctor.

Generally see patients 4 hours a day Monday to Friday but not on a Wednesday or weekends. Seems the rest of the time is spend on paperwork

There are US based heath firms buying up the practices. Which seems a strange thing to do as the doctors claim they are loss making

[jonesfam]

The Wednesday & weekend thing is more likely Golf.

[4bee]

I think Telstra Health and Telehealth types are trying to be the supermarket of health care. Some or many may even be an overseas Doctor taking some of those calls. Large corporate like Primary Health are a mixed bag of good and trash. With shockingly low out of date rebates Solo GPs are not viable I think.

Rorts are Billing items they should be using so It is a compliance issue. Care plan Item 721 723 are the ones that get up my nose. Only your regular doctor is allowed to bill them to help you access allied health care partly Medicare funded. .

We often find a person has walked in to a once off appointment and those items where billed out side the regulation/requirements. If I call Medicare to find out dates and let them know this RORT has occurred Medicare they do ZIP despite being able to see the items billed by Dr Shonky was never allowed under the rulz!

I know they are doing a compliance audit against a Doctor who bulk billed adding the bulk billing $5 incentive. The Doctor his staff added a health care card or similar which was not that persons.

Medicare can pick $5 bulk billing incentive yet I have never heard of them auditing the one hit wonders which take $100-200 odd from Medicare that they clearly should not! Those might add up to Several thousand per day - The BB incentive might be $100.

FYI The Medicare bulk billing incentive stops the day children turn 16! It should be when they finish school :rulez:

It also give a few cent to Health care card and Pension Card Holders. It should apply to all retired people in my view!:rulez:

rulz are not smart some times and not policed when they should and could be. Give me all the Medicare billing data and My prior Reconstructive accounting tool and I would have hundreds of people needing to give back millions to Medicare. Not going to happen sadly. Its easy to do.



Personally I would like just six items short Medium an complex at $ 40 $90 and $140 with a LONG consultation supplement and the same for unsociable hours being $100 more each. Over time for staff, Doctors and a security supplement if needed! My six is 9 items [biggrin]

Noting I just might sell to a corporate and run away. I would feel awful if the 8000 odd people who are often like family got shafted by that. Much prefer to sell to a GP or two in a partnership.
.


I had occasion to use a "Specialist" some years back for Post Hospital "Care". They insisted on Cash each time. & had no Facility for plastic. Eventually we realised I was being used as a Cash Cow & after 'er indoors reminded him to wash his hands after his lunch time visit to somewhere else (? a hospital we believed) we gave him the flick & saw our GP for those visits instead. All he (#1) did was check ankles (?) & take BP & ask how I was all for $300 per visit.:BigCry::wallbash::Rolling:


His waiting room was always chockas & $300 notes from everyone there was a nice little earner for a Saturday arvo, but did he charge Medicare as well? Who knows? From what you have alluded to, most probably.


His wife was always cooking him a Chinese lunch out the back of the Waiting Room if you get me drift.

My real GP pricked his ears up when we mentioned this to him but maybe he has got the arse by now. Dr Ned Kelly we named him.

[DiscoMick]

Telehealth is a good thing as it keeps people in touch with their doctors, particularly if they are remote or immobile so having to visit the surgery is difficult. Glad to see this week's announcement it is being reinstated, after being axed by the previous government.
For example, this week I needed prescriptions renewed, but my GP is fully booked to early November. A phone call to check my condition had not changed and the prescriptions were texted to my phone. Very efficient.

BTW last time I checked the Medicare levy only covered about half the actual cost of Medicare, so I support the levy being raised, since we would know it was all going into health.
I also think the Medicare rebate to doctors should be unfrozen, which should result in more bulk billing.
I also believe the federal share of public health funding should be restored to 50%, instead of expecting the states to cover 60%, to fund more beds and reduce ambulance ramping.
More beds would be released if more aged care places were funded, rather than having several thousand hospital beds (500 in Qld alone) filled with elderly people who are too frail to be sent home and should be in nursing homes.

[scarry]

Telehealth is a good thing as it keeps people in touch with their doctors, particularly if they are remote or immobile so having to visit the surgery is difficult. Glad to see this week's announcement it is being reinstated, after being axed by the previous government.
For example, this week I needed prescriptions renewed, but my GP is fully booked to early November. A phone call to check my condition had not changed and the prescriptions were texted to my phone. Very efficient.

Telehealth is a great idea for some,although our local Doctor will only do it two days a week,at a certain time,from memory between 12.00 and 1.00PM,and of course it is fully booked for weeks.

[Tote]

Link to an opinion piece from Nick Coatsworth that puts forward an interesting view. Medicare fraud is only one part of a system that needs serious reform (https://www.smh.com.au/national/don-t-protest-too-loudly-doctors-we-do-have-a-medicare-crisis-20221018-p5bqtb.html)

Regards,
Tote

[NavyDiver]

Telehealth is a good thing as it keeps people in touch with their doctors, particularly if they are remote or immobile so having to visit the surgery is difficult. Glad to see this week's announcement it is being reinstated, after being axed by the previous government.
For example, this week I needed prescriptions renewed, but my GP is fully booked to early November. A phone call to check my condition had not changed and the prescriptions were texted to my phone. Very efficient.

BTW last time I checked the Medicare levy only covered about half the actual cost of Medicare, so I support the levy being raised, since we would know it was all going into health.
I also think the Medicare rebate to doctors should be unfrozen, which should result in more bulk billing.
I also believe the federal share of public health funding should be restored to 50%, instead of expecting the states to cover 60%, to fund more beds and reduce ambulance ramping.
More beds would be released if more aged care places were funded, rather than having several thousand hospital beds (500 in Qld alone) filled with elderly people who are too frail to be sent home and should be in nursing homes.

Fully agree Mick Telehealth is usually a great thing We Love it where it fits the Medical need and a hands on Prod and Poke is not needed-

It is or should be restricted to Doctors to provide to you IF they know you and they have seen you in the last year Mick.

That rule is so a dopey Doc who doesn't know you gives you what you ask for that might KILL you due to something else your taking or some known medical issue a fast phone Doc would not have records to see from your medical history.

(PS- My Health Record is almost universally known to be almost a complete waste of time)

The Locum service our patients can call have access to a health summary if needed. Other Telehealth or those Call ME After Hours Locum Doctors ( Overseas???) do not.

Nurse on call or your Doctors after hours Locum service if very very different to the others who advertise LOUDLY who I will refrain from naming[bigwhistle]

Guess which other RULZ is broken frequently- charged to Medicare and Medicare forgets to look at:bat: Hint starts with Tele.............[biggrin]

[Tombie]

Telehealth is a good thing as it keeps people in touch with their doctors, particularly if they are remote or immobile so having to visit the surgery is difficult. Glad to see this week's announcement it is being reinstated, after being axed by the previous government.
For example, this week I needed prescriptions renewed, but my GP is fully booked to early November. A phone call to check my condition had not changed and the prescriptions were texted to my phone. Very efficient.

BTW last time I checked the Medicare levy only covered about half the actual cost of Medicare, so I support the levy being raised, since we would know it was all going into health.
I also think the Medicare rebate to doctors should be unfrozen, which should result in more bulk billing.
I also believe the federal share of public health funding should be restored to 50%, instead of expecting the states to cover 60%, to fund more beds and reduce ambulance ramping.
More beds would be released if more aged care places were funded, rather than having several thousand hospital beds (500 in Qld alone) filled with elderly people who are too frail to be sent home and should be in nursing homes.

Retired hey Mick?

I just love paying Medicare 1 & 2 twice in our household.
Plus full private cover..

Only to go to A&E for “traumatic amputation” surgery…
And as I’m checking out the staff ask me if I’m willing to pay my excess and put my treatment on insurance [emoji1787]

Let’s see…
Shared room with a suicidal occupant
The most abhorrent food

Nup!

[4bee]

Telehealth is a great idea for some,although our local Doctor will only do it two days a week,at a certain time,from memory between 12.00 and 1.00PM,and of course it is fully booked for weeks.

Hell Paul, you are not served very well in your neck of the woods are you?
'"
Can't help but feel the olde song "Who wants to be a Millionaire? from the "fillum, High Society," springs to mind or should I say Billionaire, a Million being so olde hat these days.

[bigsad]

Frank Sinatra - Who Wants to be a Millionaire (Soundtrack High Society) High Quality - YouTube (https://www.youtube.com/watch?v=YG6UllZwj9c&ab_channel=philippekogler)

[4bee]

Fully agree Mick Telehealth is usually a great thing We Love it where it fits the Medical need and a hands on Prod and Poke is not needed-

It is or should be restricted to Doctors to provide to you IF they know you and they have seen you in the last year Mick.

That rule is so a dopey Doc who doesn't know you gives you what you ask for that might KILL you due to something else your taking or some known medical issue a fast phone Doc would not have records to see from your medical history.

(PS- My Health Record is almost universally known to be almost a complete waste of time)

The Locum service our patients can call have access to a health summary if needed. Other Telehealth or those Call ME After Hours Locum Doctors ( Overseas???) do not.

Nurse on call or your Doctors after hours Locum service if very very different to the others who advertise LOUDLY who I will refrain from naming[bigwhistle]

Guess which other RULZ is broken frequently- charged to Medicare and Medicare forgets to look at:bat: Hint starts with Tele.............[biggrin]



No wonder some residents of another Sub- continent find our system phantasmagorical & there are yet many many more due to relaxation of some immigration standards.

Still, they do play cricket so they can't be all that bad.

[ramblingboy42]

somethings wrong with the system......$500k plus free new home wont get you a doctor in Julia Ck.....

[DoubleChevron]

somethings wrong with the system......$500k plus free new home wont get you a doctor in Julia Ck.....

Lets see, 6 years primary, 6 years secondary, 8 years of training .... so 20years of being stuck in a school. To go live in the middle of nowhere. After all that studying and "putting your life on hold" I'd be buggered if I shift to the backside of beyond. We aren't talking 18year olds that are ready to leave the nest. You're talking people that have spent the entire lives possibly living like paupers .... working there arses off.... that probably haven't really had a social life at all ... their friends they went to high school with have probably got married, maybe even had kids. Possibly have been working for nearly a decade in the workforce and own a house etc.... ie: "have a life" that isn't just studying like crazy.

A young doctor is going to want a life ... get out and live, I can certainly understand the last thing they wish to do is move to some remote location after spending the last 20years of your life doing nothing much other than studying every spare second of your waking hours.

bulk billing practices wouldn't be easy to make a dollar from. The place I work at used to own a lot of medical centers ... a large pathology lab and plenty of xray. I'm guessing you're probably always goiing to get either and xray or a blood test each time you see a doctor to try and spreed the bulk billing income over a few of the businesses.

I wouldn't want to work in medicine with all the stress and cost involved. just imagine being a dentist, they make huge $$$ right. Next time your there, just look around and what they are paying out for. Look at the equipment, the support staff, the overheads. It would be a pretty scary investment to take on if you ran your own practice.

No I'm a mere IT worker, not some highly educated person working in medicine. But I sure do not see the appeal of spending the first 1/3rd of your life studying.

[4bee]

Lets see, 6 years primary, 6 years secondary, 8 years of training .... so 20years of being stuck in a school. To go live in the middle of nowhere. After all that studying and "putting your life on hold" I'd be buggered if I shift to the backside of beyond. We aren't talking 18year olds that are ready to leave the nest. You're talking people that have spent the entire lives possibly living like paupers .... working there arses off.... that probably haven't really had a social life at all ... their friends they went to high school with have probably got married, maybe even had kids. Possibly have been working for nearly a decade in the workforce and own a house etc.... ie: "have a life" that isn't just studying like crazy.

A young doctor is going to want a life ... get out and live, I can certainly understand the last thing they wish to do is move to some remote location after spending the last 20years of your life doing nothing much other than studying every spare second of your waking hours.

bulk billing practices wouldn't be easy to make a dollar from. The place I work at used to own a lot of medical centers ... a large pathology lab and plenty of xray. I'm guessing you're probably always goiing to get either and xray or a blood test each time you see a doctor to try and spreed the bulk billing income over a few of the businesses.

I wouldn't want to work in medicine with all the stress and cost involved. just imagine being a dentist, they make huge $$$ right. Next time your there, just look around and what they are paying out for. Look at the equipment, the support staff, the overheads. It would be a pretty scary investment to take on if you ran your own practice.

No I'm a mere IT worker, not some highly educated person working in medicine. But I sure do not see the appeal of spending the first 1/3rd of your life studying.


That is what I used to say to my olde man.
His response was always "Get back to your homework Son, you might be a Doctor one day".


He was wrong.[bigsad]

[DoubleChevron]

That is what I used to say to my olde man.
His response was always "Get back to your homework Son, you might be a Doctor one day".


He was wrong.[bigsad]

My kids are the opposite to this .... unlike me, they really try. They are always studying and doing homework. I'm the opposite "Go out and do something ... enjoy life ... you're only young once".... I always hated school... and never wanted to be there. I've said to them many times, "Once you're out in the workforce **no-one** cares what your grades were at school" ...... If you get a degree, all employers want to see is the bit of paper saying you have a qualification. They don't know or care if you scraped through getting 49.5% for everything all the way through ... and were a crap student.

The pressure kids put themselves under these days is just insane. My daughter is currently in year 12 and it soiunds like there dropping like lemmings. The school is even advertising they have spots available in year 11 and 12 as so many are dropping out from the pressure.

seeya,
Shane L.

[4bee]

somethings wrong with the system......$500k plus free new home wont get you a doctor in Julia Ck.....


It must have some redeeming points apart from these to suit a Young-ish Doc & Family. These seem to be one offs.

things to do in Julia Creek

GET IN THE FESTIVAL SPIRIT. Got annual leave in April? ...
MEET DONALD AND DUNCAN. Never heard of a Dunnart? ...
MAKE A SPLASH. ...
VISIT THE OPERA HOUSE. ...
TAKE A CRUISE ON TWO WHEELS. ...
VISIT THE SPIRIT OF THE LIGHT HORSE SCULPTURE. ...
TAKE A WALK. ...
ENJOY A BATH.

13 Mar 2020


Maybe some are not confident in their medical skills but by hell it would be one way to gain that confidence provided that no Law Suits come their way through inexperience. As would working for the RFDS.

[3toes]

I see years study as a red herring. Wife has 8 years post school university plus had to complete 2 years supervised practice once finished university before qualified Then for rest of career has to have weekly supervision which has to pay for herself to be able to practice, earns less than a nurse

[RHS58]

somethings wrong with the system......$500k plus free new home wont get you a doctor in Julia Ck.....

Not Julia Creek, but done similar.
60-80-100 hours per week.
On call 24/7.
Called out at 2 am for several hours….doesn’t matter, still gotta turn up at 8 am for ward rounds, outpatients, emergencies, etc. Same next night. Every night. 6 weeks straight.
Wife has a career…. forget about that. Not much call for her qualifications out here.
Kids? **** them off to boarding school.
Do this 6 weeks straight, then you get a week off - if they can get somebody to cover for you. If not, tough titties, you stay.
If you have anything in the tank left for “leisure”, what’s it gonna cost to fly yourself, the missus, and kids somewhere for a week of rest? 3 days winding down, one day maybe to relax, then 3 days winding up for the return to another 6 weeks.
Don’t blame them nowadays… I wouldn’t do it for a million. Was a lot lot lot less back in my day.
Was considered a “rite of passage” back then. Supposedly made you a better doc. Yeah, right.
Absolutely admire my colleagues in the bush who have done it year after year for decades. I couldn’t.
Now retired. Done and dusted.

[ramblingboy42]

From your experience Ron , what can or should be done to arrest this almost emergency situation from becoming worse?

[RHS58]

From your experience Ron , what can or should be done to arrest this almost emergency situation from becoming worse?


So many things need to be done, changes need to be made, and it’s going to cost a lot of money, and take a lot of will by all governments - Federal and State - to make the changes.
And it’s going to take a long time. Years.
There will be Enquiries and Commissions and Reports.
We’ve seen in the media this last week that Medicare is in all sorts of strife. It needs significant change, but for decades there has been little appetite on the part of politicians of any persuasion to enact change because of the “sacred cow” that Medicare has become to Australians. Sadly the poor old cow has been milked for too long by governments, some unscrupulous providers, and even unprincipled patients, and has no more milk to give.
The cost of improving the system will be enormous.
How would Aussies feel about increasing the Medicare levy from the current 2% to 10 or 15% on top of their taxable income, which might come close to the true cost of the health system. Ouch.

Change to our health system won’t be easy, and it won’t be soon. Definitely won’t be cheap.

And I think it’s going to get worse before it gets better.

[sashadidi]

Don’t blame them nowadays…
Was considered a “rite of passage” back then. Supposedly made you a better doc. Yeah, right.
.Yeah right!!! 100% agree
Just like in New Zealand when you trained, do 80 to maybe 120 hours in the hospital, dog tired, how many "mistakes" were made? quite a few, Push back and the older Doctors would say " we did it, did us no harm" so you need to do it also....
For so called highly educated people a lot of the senior doctors had no common sense or understanding of the human condition

[RHS58]

Fatigue management policy at Qld Health not too many years ago was “drink more coffee”…
You would have been desperate to drink their Hospital Blend.

[DiscoMick]

Don't quote me, but I think I read the 2% Medicare levy covers about half the cost of Medicare. I'd be happy to see it double, on the basis the money was going to public health, a worthy cause.

So many things need to be done, changes need to be made, and it’s going to cost a lot of money, and take a lot of will by all governments - Federal and State - to make the changes.
And it’s going to take a long time. Years.
There will be Enquiries and Commissions and Reports.
We’ve seen in the media this last week that Medicare is in all sorts of strife. It needs significant change, but for decades there has been little appetite on the part of politicians of any persuasion to enact change because of the “sacred cow” that Medicare has become to Australians. Sadly the poor old cow has been milked for too long by governments, some unscrupulous providers, and even unprincipled patients, and has no more milk to give.
The cost of improving the system will be enormous.
How would Aussies feel about increasing the Medicare levy from the current 2% to 10 or 15% on top of their taxable income, which might come close to the true cost of the health system. Ouch.

Change to our health system won’t be easy, and it won’t be soon. Definitely won’t be cheap.

And I think it’s going to get worse before it gets better.

[ramblingboy42]

somethings way out of wack here.....

our "new" government , after all its pre election bull**** about the state of the planet , just gave a massive injection to the very industries which are affecting our ongoing health , which is why we have a medicare system in place.

why couldn"t 10% of the grant go to help straighten out the problems in our medical system instead of contributing to the profits of the companies causing the problems in the first place.

I know this is a bit political , but if it gets put into CA then most wont see it .....

[roverrescue]

Firstly - I have been watching this thread since inception
Biting my tongue. My feeling is the AULRO family quite likely has many more players deep on the inside of healthcare delivery than it appears in this thread.
(Thanks to NavyDiver and RHS58 for their insider trading!)

At this point I’ll just say my family and I are not currently living and working in the middle of the Torres Strait for the beach sunsets.

The public / private health model in Australia is incredibly complex and also an Australians perspective is very very location dependent. I have a pretty good handle on the Qld landscape and some idea of remote healthcare in NT and WA but would not comment on southern state services as my experience from
There is well aged!

The one point I do want to make is - despite the problems / issues / rorts / challenges & cost over runs. And not diminishing the distressing personal stories of substandard care outlined in this thread.

The Australian system as a whole - looked at with a wide lens performs admirably when you compare and account for:

-Small population base spread across a wide brown land.
-World class emergent care for ALL (there are exceedingly few nations where a citizen (or non citizen) living 1000km from a specialist cardiologist or surgeon having a life altering medical emergency would/ could receive the standard of care that an Australian really takes for granted)
-multi layered primary health system leading to a robust service across the community
-on world standards a pretty good mental health system
-a developing disability scheme that has potential to support the disadvantaged in ways unimaginable 50-100 years ago

Now don’t get me wrong - sitting around a fire I’ll rip the system to pieces and probably have too many ideas and suggestions too be helpful

But sometimes a step back and looking at what we have and appreciating the benefits can be helpful

Steve